My recent visit to Lesbos in Greece gave me a clear sense of just how much European towns and cities are struggling to cope with this refugee crisis. The capital of the Greek island has a population of 30,000 – and had just registered 15,000 refugees en masse in order to get them on to ferries heading to the mainland. Until then thousands of people, predominately refugees fleeing the war in Syria, had been sleeping rough in public parks, or in tents in parking bays at the main port.

The crisis in Europe pales in comparison to the experiences of towns and cities in the Middle East. There are more Syrian refugees in Istanbul alone than there are in the rest of Europe. In Jordan, Lebanon and Turkey, the arrival of refugees has sometimes doubled the size of hosting towns. Despite this, municipal authorities are under intense pressure to carry on providing services that residents have come to expect, while also extending these to refugees, with little or no increase in resources.

In all the many column inches on the European refugee crisis, one point has barely received a mention: the overwhelming majority of Syrian refugees are not in refugee camps. Rows of white tents in an otherwise sparse landscape are often featured in the media, but the reality is that 80% of Syrian refugees have sought refuge outside of camps, and the majority of these are living in urban areas – whether in “informal tented settlements”, rented rooms, or half-finished buildings.

David Miliband in front of a pile of discarded life vests in Lesbos. Photograph: Myrto Koutoulia/International Rescue Committee

This is not just a characteristic of displacement in the Middle East. A recent review of protracted displacement by the Overseas Development Institute showed that 59% of refugees around the world are in urban areas, and this figure grows each year. More than half of all internally displaced people (ie. displaced in their own country) are also in towns and cities.

It is not that refugees flee to urban areas because camps are full: Azraq camp in the Jordanian desert has plenty of vacancies. Only 14,000 places were filled by the end of 2014, when it has capacity for 60,000. Thousands of refugees who have been sent to Jordanian camps have left as quickly as they can – legally or illegally – preferring to fend for themselves in an urban environment rather than live in isolation and dependence.

This happens for a number of reasons. Cities are, for the most part, centres of economic growth and opportunity, where entrepreneurship and innovation are rewarded. They are also already very mixed and often socially tolerant places where, with the right support and enabling legislation, refugees can find work, educate their children, and make a productive contribution to the local economy and society, in the years before they can return home.

While the majority of Syrian refugees are not in camps, the bulk of humanitarian resources are channelled towards maintaining camps. The visible manifestation of war and flight, camps suck up vast quantities of aid money and of aid workers’ time. At one point, it was estimated that Zaatari camp in Jordan was costing $500,000 a day to run in 2014, though less than 10% of Syrian refugees in Jordan live in the camp.

The challenges for humanitarians are huge. Outside the physical confines of a camp, refugees can melt away, almost invisible and dispersed amongst the urban population. This complicates the tasks of registering, providing services, disseminating information, and ensuring refugees are aware of their rights, and able to access assistance should they experience exploitation or abuse.

Humanitarians must change too, and tailor their responses to the urban environment. Whereas in a refugee camp, almost everything must be brought in from elsewhere and a micro-society built from scratch, in urban areas, refugees’ needs can be met in ways that support existing systems and contribute to longer-term development goals – benefitting the whole population: host and refugee.

Humanitarian programmes have the potential to make the difference between dependency and development. For example, providing refugees with cash rather than in-kind goods, so they can stimulate the local economy by buying what they need. Or making sure that refugees can access education and work – critical both for contributing locally, and for rebuilding the society on their return home. Or supporting municipal authorities to provide housing for refugees, thus contributing to longer-term sustainable urban development while avoiding the creation of expensive camps.

May 2016 will see the first ever World Humanitarian Summit. Representatives of humanitarian and development agencies, affected countries and donors will meet in Istanbul to “reshape aid”.

For humanitarians, this will mean finding ways to work with municipal authorities, the local private sector, utility companies and service providers. It will require some humility – recognising that in urban areas, other people are likely to have the know-how, and that humanitarians must play a more facilitative role. Ultimately, the humanitarian system must reflect the reality of today’s urbanising world, rather than create parallel universes.